The lymphocyte-to-monocyte ratio as a predictor of overall survival in comparison to established systemic markers of inflammation in resectable colorectal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 593-593 ◽  
Author(s):  
Joseph Chan ◽  
Connie Irene Diakos ◽  
David Chan ◽  
Anthony J Gill ◽  
Alexander Engel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Glasgow Prognostic Score ◽  
Local Health ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio ◽  
Markers Of Inflammation

593 Background: The prognostic significance of systemic inflammatory markers in colorectal cancer (CRC) such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and modified Glasgow prognostic score (mGPS) have been well defined in literature. In addition, commonly utilized genetic markers such as combined BRAF-MMR status have also been found to be prognostic. Recent evidence suggests that the lymphocyte-to-monocyte ratio (LMR) may hold prognostic utility in CRC. However the LMR has still not been clearly defined in either its clinical utility or in comparsion to other established biomarkers. Methods: Consecutive patients from the Northern Sydney Local Health District undergoing curative surgical resection for colorectal cancer from January 1998 to December 2012 were collated. Of the 3281 patients identified, 1623 patients with complete pre-operative blood counts, BRAF-MMR IHC and clinicopathologic data were further analysed. Variables were analysed in univariate and then a multivariate cox regression model using forwards conditional method looking for association with overall survival (OS). Results: In multivariate analysis of 1623 patients, elevated LMR was associated with better overall survival (OS) (HR 0.565, 95% CI: 0.475-0.672, P < 0.001) independent of age (P < 0.001), T stage (P < 0.001), N stage (P < 0.001) and grade (P = 0.049). Other biomarkers such as NLR, PLR and combined BRAF-MMR status were not significantly associated with OS. In multivariate subgroup analysis of 389 patients with available mGPS data, LMR remained the only independently prognostic biomarker (HR 0.620, 95% CI: 0.437-0.880, p = 0.007). Conclusions: The LMR is an independent predictor of OS in CRC patients undergoing curative resection. Furthermore, the LMR appears to be superior to previously established biomarkers.

scholarly journals Systemic Inflammatory Markers for Predicting Overall Survival in Patients with Osteosarcoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Xiaotong Song ◽  
Hao Zhang ◽  
Fanxing Yin ◽  
Panpan Guo ◽  
Xiaocheng Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Inflammatory Markers ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Glasgow Prognostic Score ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio

Background. Inflammatory markers are associated with tumor genesis and progression, but their prognostic significance in osteosarcoma remains unclear. Therefore, we discussed the prognostic value of related inflammatory markers in osteosarcoma through a meta-analysis and systematic review. These inflammatory markers include C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), and Glasgow prognostic score (GPS). Methods. The Chinese National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journals (VIP), PubMed, Embase, and Cochrane libraries were searched. The design of meta-analysis was made based on the PICOS (population, intervention/exposure, control, outcomes, and study design) principles, and STATA 15.1 was used to analyze the data. The Newcastle-Ottawa scale (NOS) was used to assess the quality of included studies. Hazard ratios (HRs) for overall survival (OS) and disease-specific survival (DPS) were extracted for the investigation of the prognostic value of inflammatory markers. Results. Twelve researches with 2162 osteosarcoma patients were included in total. The pooled results showed that elevated NLR, CRP, and GPS are all greatly related to shortening of OS among patients with osteosarcoma ( HR = 1.68 , P = 0.007 , 95% CI: 1.15-2.45; HR = 1.96 , P = 0.002 , 95% CI: 1.28-3.00; HR = 2.54 , P < 0.0001 , 95% CI: 1.95-3.31, respectively), and CRP level is significantly associated with shortening of DPS among patients with osteosarcoma ( HR = 2.76 , 95% CI:2.01-3.80, P < 0.0001 ), additionally. However, the correlation between LMR or PLR and the prognosis of osteosarcoma is not statistically significant ( HR = 0.60 , 95% CI: 0.30-1.18, P = 0.138 ; HR = 1.13 , 95% CI: 0.85-1.49, P = 0.405 , respectively). The outcomes of subgroup analysis to NLR and CRP suggested that histology, ethnicity, metastasis, and sample size all have an impact on its prognosis of patients with osteosarcoma. Conclusion. Worsened prognosis may be related to high levels of NLR, CRP, and GPS before treatment rather than LMR or PLR, which can provide the basis for clinicians to judge the outcomes of prognosis. Trial Registration. PROSPERO (CRD42021249954), https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=249954.

scholarly journals Pre-radiosurgery leucocyte ratios and modified glasgow prognostic score predict survival in non-small cell lung cancer brain metastases patients

2020 ◽  
Author(s):  
Anna Cho ◽  
Helena Untersteiner ◽  
Dorian Hirschmann ◽  
Fabian Fitschek ◽  
Christian Dorfer ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Cox Regression ◽  
Prognostic Score ◽  
Gamma Knife Radiosurgery ◽  
Glasgow Prognostic Score ◽  
Lymphocyte Ratio ◽  
Risk Of Death ◽  
Lymphocyte To Monocyte Ratio ◽  
Modified Glasgow Prognostic Score ◽  
Nsclc Patients

Abstract Introduction The predictive value of the pre-radiosurgery Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Lymphocyte-to-Monocyte Ratio (LMR) and the modified Glasgow Prognostic Score (mGPS) was assessed for the first time in a homogenous group of NSCLC brain metastaes (BM) patients. Methods We retrospectively evaluated 185 NSCLC-BM patients, who were treated with Gamma Knife Radiosurgery (GKRS). Patients with immunotherapy or targeted therapy were excluded. Routine laboratory parameters were reviewed within 14 days before GKRS1. Results Median survival after GKRS1 was significantly longer in patients with NLR < 5 (p < 0.001), PLR < 180 (p = 0.003) and LMR ≥ 4 (p = 0.023). The Cox regression model for the continuous metric values revealed that each increase in the NLR of 1 equaled an increase of 4.3% in risk of death (HR: 1.043; 95%CI = 1.020–1.067, p < 0.001); each increase in the PLR of 10 caused an increase of 1.3% in risk of death (HR: 1.013; 95%CI = 1.004–1.021; p = 0.003) and each increase in the LMR of 1 equaled a decrease of 20.5% in risk of death (HR: 0.795; 95%CI = 0.697–0.907; p = 0.001). Moreover, the mGPS group was a highly significant predictor for survival after GKRS1 (p < 0.001) with a HR of 2.501 (95%CI = 1.582–3.954; p < 0.001). NLR, PLR, LMR values and mGPS groups were validated as independent prognostic factors for risk of death after adjusting for sex, KPS, age and presence of extracranial metastases. Conclusion NLR, PLR, LMR and mGPS represent effective and simple tools to predict survival in NSCLC patients prior to radiosurgery for brain metastases.

scholarly journals Role of Inflammatory and Immune-Nutritional Prognostic Markers in Patients Undergoing Surgical Resection for Biliary Tract Cancers

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3594
Author(s):  
Simone Conci ◽  
Tommaso Campagnaro ◽  
Elisa Danese ◽  
Ezio Lombardo ◽  
Giulia Isa ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Cox Regression ◽  
Prognostic Score ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Postoperative Mortality ◽  
Prognostic Nutritional Index ◽  
Term Survival ◽  
Lymphocyte Ratio

The relationship between immune-nutritional status and tumor growth; biological aggressiveness and survival, is still debated. Therefore, this study aimed to evaluate the prognostic performance of different inflammatory and immune-nutritional markers in patients who underwent surgery for biliary tract cancer (BTC). The prognostic role of the following inflammatory and immune-nutritional markers were investigated: Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), Prognostic Nutritional Index (PNI). A total of 282 patients undergoing surgery for BTC were included. According to Cox regression and ROC curves analysis for survival, LMR had the best prognostic performances, with hazard ratio (HR) of 1.656 (p = 0.005) and AUC of 0.652. Multivariable survival analysis identified the following independent prognostic factors: type of BTC (p = 0.002), T stage (p = 0.014), N stage (p < 0.001), histological grading (p = 0.045), and LMR (p = 0.025). Conversely, PNI was related to higher risk of severe morbidity (p < 0.001) and postoperative mortality (p = 0.005). In conclusion, LMR appears an independent prognostic factor of long-term survival, whilst PNI seems associated with worse short-term outcomes.

scholarly journals The prognostic significance of inflammation-based scores in patients with ampullary carcinoma after pancreaticoduodenectomy

2020 ◽  
Author(s):  
Shuxin Sun ◽  
Chaobin He ◽  
Jun Wang ◽  
Xin Huang ◽  
Jiali Wu ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Prognostic Nutritional Index ◽  
Significant Prognostic Factor ◽  
Entire Cohort ◽  
Lymphocyte Ratio ◽  
Survival Differences

Abstract Background Growing evidence indicates that systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with the clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of the inflammatory indexes in patients suffering from ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD). Methods We retrospectively reviewed a database of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value of survival. The survival differences of these indexes were compared by Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of progress-free survival (PFS) and overall survival (OS). Results The estimated 1-, 2-, and 3-year OS and PFS rates were 83.9%, 65.8%, 55.2% and 58.0%, 42.8%, 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and PFS when they were stratified by these inflammation-based indexes. The comparisons of AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed highest prognostic value, compared to other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor in terms of OS and PFS. Conclusion Specific inflammatory indexes, such as NLR, PLR and PI, were found to be able to predict the OS or PFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting prognosis of patients with AC after PD procedure.

Systemic inflammatory response in predicting survival in patients with operable colorectal cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 456-456 ◽  
Author(s):  
K. A. Kwon ◽  
S. Oh ◽  
S. Kim ◽  
S. Lee ◽  
J. Han ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Response ◽  
Survival Data ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Scoring Systems ◽  
Systemic Inflammatory Response ◽  
Lymphocyte Ratio

456 Background: Several inflammatory response materials could be biomarkers for prediction of prognosis of cancer patients; elevated C-reactive protein (CRP), increased white cell, neutrophil, platelet, and decreased albumin. The Glasgow Prognostic Score (GPS) combines circulating CRP and albumin level, the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR) has been introduced for prognostic scoring system in colorectal cancer (CRC). Thus, in this study, we attempted to identify an more adequate prognostic model related with systemic inflammatory response for CRC. Methods: Between Mar 2005 and Dec 2008, 200 patients who underwent curative resection for colorectal cancer were enrolled in this study. Systemic inflammatory parameters (CRP, albumin, neutrophil, lymphocyte, and platelet count) were checked for making 3 scoring systems. Based on clinical survival data, we then compared PFS and OS with GPS, NLR, and PLR. Results: Male to female were 123:77. Median age of the patients was 64 years (range, 26-83 years). Median follow-up duration was 27.2 months (range 7.8-52.7 months). 36 patients were observed disease progression or death. 19 patients were passed away during follow-up duration. 3 year PFS and OS were 72% and 86%, respectively. Numbers of GPS 0,1, and 2 patients were 154 (77%), 44 (22%), and 2 (1%), respectively. Survival analysis according to GPS, PFS and OS could not be able to show the prognostic significance (P=0.313 and P=263). Cut-off value of NLR and PLR were determined 3 and 180 by ROC curve. Both of NLR and PLR were observed as a good prognostic biomarker of PFS and OS (P=0.009 and P<0.001 in PFS, P=0.006 and P=0.001 in OS). Conclusions: Although GPS, NLR, and PLR were introduced as prognostic scoring systems for operable CRC, PLR which is constructed of platelet/lymphocyte count may represent a useful prognostic index for the prediction of PFS and OS in operable CRC. No significant financial relationships to disclose.

scholarly journals Prognostic indices of inflammatory markers, cognitive function and fatigue for survival in patients with localised colorectal cancer

ESMO Open ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. e000302 ◽  
Author(s):  
Janette L Vardy ◽  
Haryana Mary Dhillon ◽  
Gregory R Pond ◽  
Corrinne Renton ◽  
Stephen J Clarke ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cognitive Function ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Full Blood Count ◽  
Prognostic Impact ◽  
Prospective Longitudinal Study ◽  
Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Prospective Longitudinal

BackgroundInflammation promotes the development of malignancy, while a variety of systemic markers of inflammation predict for worse cancer outcomes including recurrence and survival. Here, we evaluate the prognostic impact of cytokine concentrations, full blood count (FBC) differential ratios, cognitive function and fatigue on survival in patients with localised colorectal cancer (CRC).Patients and methodsData are from a prospective longitudinal study comparing cognitive function and fatigue in patients with CRC who did (n=173) and did not (n=116) receive adjuvant/neoadjuvant chemotherapy. Baseline blood results (prior to any chemotherapy) included cytokines and FBC from which neutrophil lymphocyte ratio, lymphocyte monocyte ratio, platelet lymphocyte ratio and platelet monocyte ratio were derived. Fatigue was measured with the Functional Assessment of Cancer Therapy-Fatigue subscale and cognitive function by a neuropsychological test battery. Kaplan-Meier methods were used to estimate disease-free survival (DFS) and overall survival (OS). Univariable and multivariable Cox regression analyses were performed to evaluate factors potentially prognostic of outcomes.ResultsAt a median follow-up of 91.2 months, 227 subjects (79%) are still alive, and 212 (73%) have no evidence of a recurrence. Five-year OS and DFS are 86% (95% CI 81% to 90%) and 77% (95% CI 71% to 82%), respectively. None of the cytokines (interleukin (IL-6), IL-1 and tumour necrosis factor) or differential ratios of blood components, fatigue or cognitive function was statistically related to DFS or OS. Patient educational status (P=0.018), stage of disease (P=0.032), alanine transaminase (P=0.003), lactate dehydrogenase (P=0.008) and carcinoembryonic antigen (P=0.002) were significant as prognostic covariates of OS in univariable analyses, with similar results for DFS.ConclusionNone of the a priori selected markers of inflammation, fatigue or cognitive function was associated with OS or DFS in this cohort of patients.Trial registration numberNCT00188331, Post-results.

scholarly journals The prognostic significance of inflammation-based scores in patients with ampullary carcinoma after pancreaticoduodenectomy

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuxin Sun ◽  
Chaobin He ◽  
Jun Wang ◽  
Xin Huang ◽  
Jiali Wu ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Significant Prognostic Factor ◽  
Entire Cohort ◽  
Lymphocyte Ratio ◽  
Survival Differences

Abstract Background Growing evidence indicates that the systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of inflammatory indexes in patients with ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD). Methods We retrospectively reviewed the data of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value for survival. The survival differences of these indexes were compared by the Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of disease-free survival (DFS) and overall survival (OS). Results The estimated 1-, 2-, and 3-year OS and DFS rates were 83.9, 65.8, and 55.2% and 58.0, 42.8, and 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and DFS when patients were stratified by these inflammation-based indexes. The comparisons of the AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed the highest prognostic value, compared to the other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor for OS and DFS. Conclusion Specific inflammatory indexes, such as NLR, PLR and dNLR, were found to be able to predict the OS or DFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting the prognosis of patients with AC after the PD procedure.

Prognostic significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in untreated and treated stage IV non-small cell lung cancer (NSCLC): An Australian cancer centre experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20630-e20630
Author(s):  
Hiren A. Mandaliya ◽  
Mark Jones ◽  
Christopher Oldmeadow ◽  
Ina Nordman
Keyword(s):  
Cox Regression ◽  
Strong Association ◽  
Prognostic Significance ◽  
Stage Iv ◽  
Post Treatment ◽  
Lymphocyte Ratio ◽  
Start Date ◽  
Predictive Variables ◽  
Lymphocyte To Monocyte Ratio ◽  
Unit Increase

e20630 Background: Baseline high NLR predicts poorer outcome in stage IV NSCLC; post-treatment variation in NLR and potential impact on overall survival (OS) is not clear in this group. Prognostic implications of PLR and LMR are not well studied for stage IV NSCLC. We aimed to assess the prognostic role of NLR, LMR and PLR in stage IV NSCLC at diagnosis and post-treatment. Methods: A retrospective descriptive study of 279 patients with Stage IV NSCLC treated at our centre over five year period (2010 to 2015). NLR, PLR and LMR calculated at diagnosis and post first cycle chemotherapy/targeted treatment. Demographic variables summarized. Estimates of Kaplan-Meier survival distributions for OS were generated. Cox regression used to derive OS hazard ratios of predictive variables. Approval from ethics committee obtained. Results: Baseline NLR, PLR and LMR showed strong association with OS. A five-unit increase at baseline (treatment start date) in NLR was associated with an 11% increase in the hazard of death (HR = 1.115, 95% CI: 1.077-1.148) while the same increase in PLR was associated with 0.5% increase in the hazard of death (HR = 1.005, 95% CI:1-1.005). A five-unit increase in LMR at baseline was associated with a 50% reduction in the hazard of death (HR = 0.50, 95% CI:0.260-0.956). Post-treatment NLR, PLR and LMR were examined in 221 patients. Fitted models incorporating adjustment for baseline values demonstrated that increasing NLR correlated with a shorter OS (HR = 1.574, 95% CI:1.295-1.917) but no statistically significant relationship could be demonstrated for PLR nor LMR. Conclusions: While NLR, PLR and LMR showed significant associations with OS prior to treatment, only NLR showed an association with OS after treatment. OS was shorter for high NLR and high PLR at baseline compared to low NLR and low PLR at baseline. OS was longer for high LMR at baseline compared to low at baseline. An increase in NLR post-treatment correlated with a shorter OS. This is the first study examining the prognostic significance of all three ratios in patients with untreated and treated stage IV NSCLC.

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